TORONTO, ON (April 1, 2026) – The Nurse Practitioners Association of Ontario (NPAO) is deeply disappointed that the Ontario government has not yet provided clarity on its plans to respond to the expectations outlined in Canada Health Act interpretation letter. The letter, which was issued in January 2025, directed provinces and territories to include services provided by Nurse Practitioners (NPs) in publicly funded health insurance plans by April 1, 2026. NPAO is dismayed and concerned that there have been no visible efforts by the provincial government to develop the funding models required to better integrate NPs into Ontario’s healthcare system.
“The lack of clarity on the interpretation letter has caused significant uncertainty, confusion, and anxiety for NPs and patients alike,” said Dr. NP Michelle Acorn, CEO of NPAO. “On multiple occasions, we have requested additional information on the provincial government’s progress and offered our perspectives. This information has not been provided and consultation has been minimal.”
Currently, NPs and patients are left without certainty on billing and affordability of medically necessary services. NPAO strongly encourages the Minister of Health to work with NPs to develop and implement funding models that will enable the province to fulfill its duties under the Canada Health Act, increase access to care for patients, and appropriately and equitably compensate NPs for services provided. These models have the potential to catalyze workforce expansion, reducing wait times and barriers to care.
Importantly, these models also better enable NPs to practice as autonomous leaders – not just within teams. While team-based care is an effective method of meeting patient needs, it is not the only solution to the ongoing challenges faced by our healthcare system. NPs are leaders with extensive education, experience, and expertise; they practice in all sectors across the healthcare system, including primary and specialty care. Empowering NPs to practice to the fullest extent of their scope – and providing the necessary funding to do so – optimizes Ontario’s healthcare workforce to more efficiently and effectively provide care.
“Time and time again, the data has shown that NPs represent the future of healthcare in Ontario and are ideally positioned to enable its transformation. Under the status quo, we remain an untapped resource.” emphasized Dr. NP Acorn. “We have a generational opportunity for Ontario to mobilize its health workforce and better serve Ontarians. Let’s embrace it.”
NPAO values its relationship with the provincial government and remains committed to ongoing collaboration. Ontario has historically been a leader in supporting NPs – and can still be a leader. The enforcement deadline for the Canada Health Act interpretation letter is April 1, 2027, after which Ontario risks deductions from federal health transfer payments. As the voice for NPs in Ontario, NPAO will continue to work with the provincial government, allied organizations, and healthcare leaders across Ontario to enable the urgent development and implementation of flexible funding models that better support NPs and patients alike.
